By Liz Highleyman

Several studies have shown that people with chronic hepatitis C have an increased risk of developing insulin resistance and diabetes mellitus, but it is not clear whether this excess risk can be reduced with interferon-based therapy.

As reported in the March 2009 issue of Hepatology, Japanese researchers retrospectively analyzed the incidence of and predictive factors for type 2 (also known as adult-onset) diabetes in 2842 hepatitis C patients who did not have diabetes at baseline and who were treated with conventional interferon, either as monotherapy (n = 2417) or in combination with ribavirin (n = 425).

Over a mean follow-up period of 6.4 years, overnight (12-hour) fasting blood samples or casual blood samples were regularly collected to test for development of diabetes.

Results

36.7% of patients who received interferon monotherapy and 68.0% of those treated with interferon plus ribavirin achieved sustained virological response (SVR).

143 of the 2842 participants (5.0%) developed type 2 diabetes during follow-up.

Cumulative diabetes incidence rates were 3.6% at 5 years, 8.0% at 10 years, and 17.0% at 15 years.

In a multivariate analysis, diabetes incidence after completion of antiviral therapy was significantly associated with:

Advanced liver fibrosis (hazard ratio [HR] 3.3; P < 0.001);

Lack of sustained virological response (HR 2.7; P < 0.001);

Presence of "pre-diabetes," or elevated blood glucose, at baseline (HR 2.2; P < 0.001);

Age > 50 years (HR 2.1; P < 0.001).

In conclusion, the study authors wrote, "Our results indicate sustained virological response causes a two-thirds reduction in the risk of type 2 diabetes development in HCV positive patients treated with interferon."

Department of Hepatology, Toranomon Hospital, Tokyo, Japan

4/21/09

Reference
Y Arase, F Suzuki, Y Suzuki, and others. Sustained virological response reduces incidence of onset of type 2 diabetes in chronic hepatitis C. Hepatology 49(3): 739-744. March 2009. (Abstract).